Global airway disease: mepolizumab simultaneously improves outcomes in severe CRSwNP and asthma

Chronic rhinosinusitis with nasal polyps (CRSwNP) often co-exists with asthma and non-steroidal anti-inflammatory drug- exacerbated respiratory disease (N-ERD), creating a more severe phenotype and an additional burden compared with CRSwNP disease alone (1-3). The relationship between these diseases in terms of shared immunological disbalance has been coined in the literature as ‘global airway disease’ or ‘unified airway disease’ and requires integrated treatment strategies (4-6). Our post hoc analysis of the Phase III randomised, double-blind, placebo-controlled, multicentre SYNAPSE study (GSK ID: 205687; NCT03085797 (7)) assessed the efficacy of mepolizumab, an anti-interleukin-5 monoclonal antibody, in simultaneously improving both CRSwNP and asthma outcomes versus placebo. By utilising a combined measure that accounts for quality of life, sinonasal symptoms and asthma control, we aimed to validate the potential of mepolizumab as an effective therapeutic option for global airway disease.